Treating Heroin and Opioid Addiction

Treating Heroin and Opioid Addiction

Governor Wolf and his administration are working to provide real solutions to save lives and help addicted individuals and their families get the treatment they need to live long, productive lives. This guide will connect you with heroin and opioid addiction services.

Suffering from the disease of addiction and need treatment? Call the Hotline 1-800-662-HELP to speak to a professional.

Get Treatment

There are a number of ways to find treatment for those suffering from the disease of addiction.

Call the Hotline 1-800-662-HELP

Are you or someone you know suffering from a prescription drug or heroin problem? We can help. Call 1-800-662-HELP (4357) for information about treatment resources. Your call to 1-800-662-HELP is completely confidential. This hotline, staffed by trained professionals, is available 24 hours a day, seven days a week and is available in both English and Spanish. Call 1-800-662-HELP.

Find a County Single County Authority

There are a wide variety of substance and alcohol abuse services available to Pennsylvanians. Community substance abuse programs are administered through county program offices called Single County Authorities (SCAs.)

The SCA determines a person’s eligibility for service funding, assesses the need for treatment or other services, and makes referrals to appropriate programs to match treatment and/or service needs. More information about county SCAs .

Find a Center of Excellence

You can also find treatment by reaching out to a Center of Excellence. Centers of Excellence help ensure that people with opioid-related substance use disorders stay engaged in treatment to receive follow-up care and are supported within their communities. The centers coordinate care for people utilizing a team-based approach that is focused on treating the “whole person,” with the explicit goal of integrating behavioral health and primary care. More information about Centers of Excellence .

To find a Center of Excellence near you, view the map below:

Find a Care Provider

You can also find help by reaching out directly to care providers near you. A care provider is a place that provides treatment options for those suffering from the disease of addiction.

What is Naloxone?

Naloxone is a medication that can temporarily reverse an overdose that is caused by an opioid drug (prescription pain medication or heroin). When given during an overdose, naloxone blocks the effects of opioids on the brain and restores breathing within two to eight minutes. Naloxone has been used safely by medical professionals for more than 40 years and has only one function: to reverse the effects of opioids on the brain and respiratory system in order to prevent death. Naloxone has no potential for abuse- a person can’t get high or become addicted to it — and it is safe to use. Naloxone does not work to reverse overdose from other types of substances. Find out how to get Naloxone.

Get Naloxone

How do I get naloxone?

Family members and friends can access this medication by obtaining a prescription from their family doctor or by using the standing order (a prescription written for the general public, rather than specifically for an individual) issued by Rachel Levine, M.D., PA Physician General. The standing order is kept on file at many pharmacies, or may be downloaded here (PDF) from the Department of Health’s website.

Naloxone prescriptions can be filled at most pharmacies. Although the medication may not be available for same day pick up, it can often be ordered and available within a day or two.

What types of naloxone are available?

Two of the most common ways that naloxone is administered are intranasal (nasal spray) and the auto-injector. Please note, not all pharmacies stock both forms and insurance coverage may vary depending on the type of medication being purchased and each individual insurance plan. Check your insurance prescription formulary or call your benefits manager to determine if the medication is covered by your particular plan or if your purchase of the medication will be an out-of-pocket cost.

Intranasal currently has two pieces that are easily assembled: a prefilled medication tube and an atomization device which is sold separately. The nasal piece may not be stocked at your local pharmacy; however, they may assist in ordering it. Additionally, the nasal atomization device can be ordered from a number of medical supply companies without a prescription.

The Auto-injector comes in a manufactured dosage form (similar to an epi-pen) and has a recorded message to talk you through giving the medication.

Does insurance cover naloxone?

Insurance companies vary in how they cover naloxone and other drugs used to treat an opioid overdose. Prior to having a naloxone prescription filled with a pharmacy, consumers are encouraged to check with their insurance carriers to find out whether naloxone is a covered benefit under their policy, and, if so, what form of naloxone is covered, and any cost-sharing amounts that may apply under their policy.

Will Fee-for-Service and the managed care organizations (MCOs) pay for naloxone dispensed under the standing order for Medical Assistance recipients?

Yes.

Will Medical Assistance require a prescription in order for the pharmacist to fill the naloxone for a Medical Assistance recipient?

Yes, per 55 Pa Code, Chapter 1121 — Pharmaceutical Services — §1121.52, pharmacists can treat the standing order as a verbal order for Medical Assistance recipients.

Can a person other than the eligible Medical Assistance recipient (friend or family member) obtain the naloxone at the pharmacy on the recipient's behalf? Will the Medical Assistance Program make payment?

PA Medical Assistance will make payment for naloxone for the eligible Medical Assistance recipient.

Is prior authorization required by Medical Assistance for any of the naloxone products or supplies?

The Evzio Auto-Injector is covered by Medical Assistance, but requires prior authorization. Generic naloxone is covered without the need for prior authorization.

Where can a pharmacy access Medical Assistance billing procedures for naloxone and the nasal actuator?

The Fee-for-Service Program will post information related to billing for naloxone on the DHS Pharmacy Services website . Pharmacies will need to contact each MCO individually to obtain information about their billing procedures.

Will copays apply for the naloxone products and nasal actuator?

No, the Medical Assistance copay will not apply.

Is there a limit to the number of times that a Medical Assistance recipient can get naloxone?

No, there is no limit to the number of fills that can be obtained.

The Magnitude of the Epidemic

This epidemic affects every walk of life. Rich, poor, black, white, young, or old — the opioid crisis is unprejudiced in its reach and devastation. At least ten Pennsylvanians die every day from a drug overdose, with over 3,500 overdose deaths in Pennsylvania in 2015 alone.

How to Use Naloxone

How do I administer naloxone?

When given during an overdose, Naloxone blocks the effects of opioids on the brain and restores breathing within two to eight minutes. Below is a brief instructional video that shows how to administer Naloxone.

In addition to watching the video above and talking to your healthcare provider or the pharmacist about how to use naloxone, you are encouraged to take an online training through a Department of Health approved Naloxone resource site: Get Naloxone Now or PA Virtual Training Network .
These easy to understand, brief trainings explain how to recognize the signs and symptoms of an opioid overdose, what to do in the event of an overdose, and instruct on how to give naloxone. While it is not necessary to obtain a training certificate in order to purchase naloxone, learning these important details will help you respond properly in the event of an overdose and also meet the immunity requirements of PA Act 139.

Could I get in trouble for giving someone naloxone (statutory immunity)?

Good Samaritan: Through the ‘Good Samaritan’ provision of Act 139, friends, loved ones and bystanders are encouraged to call 911 for emergency medical services in the event an overdose is witnessed and to stay with the individual until help arrives. The provision offers certain criminal and civil protections to the caller so that they cannot get in trouble for being present, witnessing and reporting an overdose.
Administering Naloxone: Physicians are permitted to write third party prescriptions for naloxone and you are immune from liability for giving naloxone if you believed the person was suffering from an opioid overdose (heroin or prescription pain medication) and you called for medical help/911 after giving the medication.

What do I do if I am a first responder at the scene of an overdose?

What are the Do's and Don'ts in responding to an opioid overdose?

DO support the person’s breathing by administering oxygen or performing rescue breathing.
DO administer naloxone.
DO put the person in the “recovery position” on their side, if he or she is breathing independently.
DO stay with the person and keep him/ her warm.
DON’T slap or try to forcefully stimulate the person — it will only cause further injury. If you are unable to wake the person by shouting, rubbing your knuckles on the sternum (center of the chest or rib cage), or light pinching, he or she may be unconscious.
DON’T put the person into a cold bath or shower. This increases the risk of falling, drowning or going into shock.
DON’T inject the person with any substance (salt water, milk, “speed,” heroin, etc.). The only safe and appropriate treatment is naloxone.
DON’T try to make the person vomit drugs that he or she may have swallowed. Choking or inhaling vomit into the lungs can cause a fatal injury.

Where can I get trained to administer naloxone?

For EMS agencies licensed through the Department of Health, and for certified EMS providers, training will be provided through the Department of Health’s Learning Management System.

For law enforcement, fire departments, and other persons not currently licensed by the Department of Health:

For training of law enforcement officers by law enforcement officers: The PA Virtual Training Network training on naloxone can aid every law enforcement agency and professional in the Commonwealth of Pennsylvania. In order to access PAVTN.net, you must be registered as a member of the site. Typically, officers are registered by their departments to complete courses.

Dispensing Naloxone

The Fee-for-Service Program posts information related to billing for naloxone on the DHS Pharmacy Services website . Pharmacies will need to contact each MCO individually to obtain information about their billing procedures.
If you are a pharmacist in Montgomery or Allegheny County, please note that there are also standing orders in your county. In addition, CVS has developed a standing order for their pharmacies nationwide.
You can also take the time to review the Opioid Dispensing Guidelines maintained by the Pennsylvania Department of Health.

If I'm a first responder, what do I need to know for administering naloxone?

If I’m a school administrator or official, what resources are available to me?

As outlined in their position statement , the National Association of School Nurses (NASN) believes that the safe and effective management of opioid-related overdose in schools should be incorporated into the school emergency preparedness and response plan.

Soon after, Governor Wolf and the Pennsylvania Departments of Health, Education, State, and Drug and Alcohol Programs announced a statewide partnership with Adapt Pharma to provide a free, two dose carton of Narcan (naloxone hydrochloride) Nasal Spray to public high schools across Pennsylvania.

Drug Take-back Boxes

The Department of Drug and Alcohol Programs, in partnership with the Pennsylvania Commission on Crime and Delinquency (PCCD), the Office of the Attorney General, the National Guard, and the Pennsylvania District Attorneys Association (PDAA), spearheaded a greatly-expanded prescription drug take-back box program to greatly reduce the amount of prescription drugs available for potential misuse and abuse.

Through grants, this program has placed 580 take-back boxes across all 67 counties. In 2016, approximately 124,336 pounds of prescription drugs were collected and destroyed. Since its start in January 2014, approximately 227,857 pounds of prescription drugs have been collected and properly destroyed.

Naloxone is also available at most pharmacies across the state year-round. Secretary of Health Dr. Rachel Levine issued this standing order prescription to any Pennsylvanian to get naloxone for anyone who may need it.

WHO: Dr. Rachel Levine, Secretary of Health, Dr. Michael Ashburn, Professor of Anesthesiology and Critical Care Director at the Penn Pain Medicine Center, Dr. Jeanmarie Perrone, Professor of Emergency Medicine at the Perelman School of Medicine at the University of Pennsylvania

WHAT: To announce the latest prescribing guidelines from the Safe and Effective Prescribing Practices Task Force.

Wednesday, December 12, 2018

WHAT: DDAP Secretary Jennifer Smith and Geisinger officials will discuss the importance of the Pennsylvania coordinated Medication-Assisted Treatment (PacMAT) programs. Geisinger’s program is one of eight that has received funding from the state and is part of a hub and spoke model of treatment.

WHO: Department of Corrections officials will discuss the Laurel Highlands facility and the opioid treatment center they have there. Officials will also discuss Corrections’ Medication Assisted Treatment, as well as the entire corrections system perspective. Also working to have inmates available to be interviewed about their addiction and the treatment they receive.

Thursday, December 13, 2018

WHEN: 11:00 am to 7:00 pm, except for a few instances as otherwise noted

WHO: State Health Centers, County and Municipal Health Departments and public entities, partnering with the Single County Authorities

WHAT: These entities will provide naloxone for free to people. There are no requirements, no ID needed, no fee, etc. As the Surgeon General has recently said, everyone can be a first responder and can assist someone who has an overdosed, whether that is a loved one or someone you come across.

WHAT: Aging, with support from other state agencies, will announce the Grandparents Raising Grandchildren Work Group as part of the continued efforts to help grandparents who are raising grandchildren as part of the opioid crisis.

WHAT: Secretary Miller will visit the CleanSlate Williamsport center. CleanSlate has seven facilities across the state, including several COEs. COEs provide treatment that is team-based and whole-person focused, with a goal of integrating behavioral health and primary care that keeps people engaged in treatment longer and sets a strong foundation for recovery. Nearly 15,000 have entered into treatment since the COEs launched first launched.

WHAT: Department of Aging officials will join DePietro’s pharmacy to discuss the importance of drug take back locations across the state, including those at local pharmacies, and the importance of properly disposing unused medication.

WHAT: DCNR and DOH officials will discuss the importance of naloxone and of park rangers carrying naloxone, and the importance of the outdoors in one’s overall health and wellness.

Opioid Addiction and the Wolf Administration

The Wolf Administration has made the fight against opioid abuse and heroin use a top priority. Since Governor Wolf took office, he and his administration have worked with the General Assembly to take aggressive steps to combat the disease of addiction, making Pennsylvania a national leader in the fight.

Governor Wolf recently signed a first-of-its-kind statewide disaster declaration to enhance state response, increase access to treatment, and save lives. This disaster declaration will bolster the administration’s existing response by speeding up and expanding access to treatment, improving tools for families, first responders, and others, and further enhancing coordination and data collection to improve state and local response.

Governor Wolf has also provided funding to implement 45 centers of excellence (COE) throughout the commonwealth that will treat nearly 11,000 people with substance use disorder. Governor Wolf also signed legislation that limits the number of opioids a patient can receive at emergency rooms to a seven day supply with no refills, and put the same restriction in place for minors no matter where they get a prescription.

Additional steps the Wolf Administration has taken to combat this crisis include:

– Launching a prescription drug monitoring program that allows prescribers and dispensers to monitor who is obtaining opioids, who prescriptions are being obtained from, and how often they are prescribed.

– Launching a 24/7 helpline, 1-800-662-HELP, for those who need immediate assistance with drug and alcohol problems.

Every day we lose ten Pennsylvanians to the disease of addiction. This disease does not have compassion, or show regard for status, gender, race, or borders. It affects each and every Pennsylvanian, and threatens entire communities throughout our commonwealth. While this is not the end of our efforts on this crisis, we have made great progress on battling this public health crisis.